Qualifications

• 3+ years of experience in Medicaid program administration or provider enrollment.
• Knowledge of Medicaid Waiver programs in states like IN, TX, FL, or MN.
• Familiarity with National Provider Identifier (NPI) and Local Provider Identifier (LPI) processes.
• Strong organizational and project management skills.
• Ability to interpret and summarize regulatory documents.
• Proficiency in Microsoft 365.
• Experience in senior living or home and community-based services (HCBS).
• Background in negotiating rates with Managed Care Organizations (MCOs).
• Familiarity with Medicaid cost reporting.
• Experience in a multi-site operations environment.

Responsibilities

• Monitor Medicaid legislation and policy changes across all operating states.
• Translate regulatory changes into actionable guidance for leadership.
• Maintain knowledge of allowed room and board rates by state.
• Document Medicaid Waiver program details for new states.
• Manage renewal of existing Medicaid contracts to ensure compliance.
• Establish new contracts with Managed Care Entities as needed.
• Negotiate reimbursement rates with payers where applicable.
• Research and verify provider identifiers for communities.
• Apply for new NPIs and LPIs for expanding communities.
• Assist communities in applying to be approved Medicaid Waiver providers.
• Track legislative developments impacting estate recovery criteria.
• Serve as a resource for community leadership on program requirements.
• Identify and address knowledge gaps across communities.
• Supervise billing specialists and ensure timely Medicaid billing activities.

Benefits

• Comprehensive healthcare plan options.
• 401(k) retirement plan with company match.
• Professional development opportunities.
• Flexible work schedule options.
• Supportive team environment and resources for staff.